Tarita Pakrashi

We started fertility treatments with Dr. Pakrashi about 7 years after my husband froze sperm due to a second diagnosis of testicular cancer with a second orchiectomy that would leave him sterile. Reviewing my health and cycle regularity it looked like we would have a pretty simple IVF case. Her positivity lead us to choose a single cycle with ICSI and PGS. Stimmming went well, 12 eggs were retrieved, 5 made it to day 5. 2 were abnormal, 2 normal, and 1 with no results. Our first FET failed, which seemed unlikely, so we moved forward with an ERA test that found I was prereceptive. I loved that Dr. Pakrashi suggested this sooner rather than waiting for multiple failed transfers. Our second FET also failed to implant. She was very helpful and supportive in deciding to move forward with another FET with the embryo that had no results. Unfortunately the cycle was postponed due to COVID19. Overall, we’ve had a positive experience, but I wish we were provided more details and information without having to ask first. We often feel like they (the clinic as a whole) keep reports simple and if we didn’t ask questions we’d be more lost and confused. We don’t always feel confident in our knowledge, but we’re comforted by Dr. Pakrashi’s openness and willingness to talk us through anything.

Ask questions. You are your own best advocate. Read before you go to appointments and clarify anything that leaves you unsure.

For stimming we used menopur and gonal f. I reacted perfectly to the meds and the clinic was very happy with the 12 eggs retrieved. For the FET cycles I’ve had the protocol has remained the same using estradiol patches, intravginal estradiol pills, and PIO injections. After my first failed FET Dr. Pakrashi suggested an ERA that found me prereceptive; therefore my second FET was adjusted slightly for me to be on PIO injections for 6 days.

Dr. Pakrashi strongly suggested single embryo transfers.

I really loved Dr. Pakrashi. She has since left the clinic and I cried when she told me she was leaving. I loved that she included Eastern medicine and practices in with the IVF treatment plan. Whenever I had a question or questioned anything, she always took it seriously and answered me. I felt like she was our personal cheerleader, like we were her only patients. She really takes time to get to know you and be there for you.

Trust her but do not be afraid to voice any questions or fears.

I am 36 with an AMH of .299 with male factor (morphology). Pre-retrieval daily supplement, etc: 88 mg Thyroid pill 75 mg DHEA 600 mg ubiquinol Vit D supplements Plus prenatal and fish oil 1x weekly acupuncture (started two months before retrieval) 1-2x weekly yoga No strenuous workouts one month prior Recommended no coffee or alcohol (I abstained for 2+ months prior to retrieval). I did not eat gluten and dairy for one month prior to my start date. Stim protocol (day three start): 5 days of clomid 150 of menopur 150 of gonal F 4 syringes of ganarelix Pregnyl Trigger They counted 7 follicles and retrieved 6 eggs. 5 fertilized and 2 embryos made it to blast. We have a 4AA and 4CB graded embryos.

We have a high deductible plan so once we hit our deductible, all costs have been covered thus far except for anesthesia.

My experience trying to conceive is from a multi-disciplinary approach, as I have several specialists working together to ensure a safe future pregnancy due to health conditions I live with. She is willing to compromise with other doctors and cater to their concerns as they arise, and the best part is that I have reassurance that none of these small hurdles will interfere with fertility treatments. She puts the patient's health above all and wants the patient to live a fully normal life, unlike many other reproductive endocrinologists who set limit upon limit during the course of your cycle.

Voice your concerns. She is always willing to listen and help out, so there's no need to hide your insecurities, frustrations or concerns.

On cycle day(CD) 1, I call the office to schedule an ultrasound. On CDs 3-7, I take 5 mg of letrozole. Around CD 12-13, I go in for an ultrasound. Usually it's CD 11-12 for others, but I tend to ovulate later. Based on the ultrasound, I may have to come back if the follicles and lining are not the right size. Otherwise, I will be instructed on taking ovidrel. Twenty four to 36 hours or so later, I will go in for IUI. Two days later, I will start progesterone. Fourteen days after that, I will test at home. If negative, I stop progesterone and call on day 1 to repeat cycle. If positive, I go in for a blood pregnancy test. I'm not sure what happens after that. Letrozole has done wonders for my ovulation ability. I used to not ovulate, but now I'm producing one or two mature follicles, which makes me feel confident I'm going in the right direction.

Ultrasounds (if not paid for by insurance) are $190...luckily mine are covered. IUI(self-pay) is $255. I pay $55 for them to wash my husband's frozen sperm along with that. He gave a sample and is storing it in the cryo lab. He gave enough for 6 vials to be stored. For a year of storage, we paid $450. Everything requires payment up front. I was told only with IVF do they offer payment plans.

There are no weaknesses I can report on. My first doctor, I felt like a number. He didn't deter from treatment protocol based on my response of first IVF to our 2nd. I had seen Dr Pak a few times during the course of my treatments and knew I wanted her to head my 3rd IVF transfer. We changed protocol completely based on my previous responses. I was worried that I might be resistant to clomid so she suggested a trial run with timed intercourse to see my response before we moved forward. She is a great listener. She is compassionate and truly wants what is best for you. She allows you to be an advocate for yourself. She will discuss research and new studies with you. Etc. She encourages you to do your own research and will talk to you about your findings. She is top notch and I am hopeful for this next round.

If you have questions, don't be afraid to ask. If there is something you want to try, don't be afraid to ask. She is warm and inviting.

We have not started our cycle but did do a clomid test trial and I responded beautifully. I am considered a poor responder and my last 2 IVF I was on max dose. She suggested a clomid/menopur min stimulation. I responded beautifully in our clomid test run, better than my IVFs. We are looking forward to our new protocol and hopeful we will get pregnant.

IUI $600 IVF range $6500-8000

She lets you decide. But the clinic won't transfer more than 2.

Dr Pakrashi is very compassionate and obviously cares for her patients and their outcomes. She listens and is very personal. She completes follow through by personally calling me to inquire how I'm feeling and be sure I understand the next step in the IVF process. Our situation is unique in that prior to IVF we had 2 pregnancy losses. After that we used clomid and had our daughter in 2013. Wanting 1 more child and a sibling for our daughter, we tried to conceive again. Sadly we went on to have three pregnancy losses over the next 3-4 years, all three males diagnosed with arthrogryposis. Test after test left us with no reasoning why the reoccurrence happened. Heartbroken, but wanting to give it one last attempt to complete our family we looked into IVF with gender selection. Through many years of genetic counseling we thought if we could choose a female embryo that we could finally complete the family we have dreamed for (and stop the gut wrenching pain of recurrent loss). Dr Pakrashi listened, showed empathy and gave us hope. We could only financially do 1 IVF cycle, unfortunately there was not a normal female embryo for FET. Dr Pakrashi and the embryologist personally called to speak with us about our results in detail.

IVF was new for us. I thought I had read everything before I went in for the consultation and would remember what to ask. I would advise a prospective patient to bring your questions written down and have a notebook to take notes.

Menopur 150 morning and night Gonal F 300 units morning and night Cetrotide 0.25 mg x2 doses Lupron 40 units x 2 doses Started day 3 of menstrual cycle 13 eggs retrieved, 9 fertilized, 6 biopsied, 2 females, 4 males. No viable embryo for FET.

$6750- Medications $400- Anesthesia $13,600- IVF circle with FET $600- Pre IVF testing All because our insurance doesn't cover any portion of IVF.

We only wanted to electively transfer 1 single female embryo. Dr Pakrashi agreed with us.

Dr. Pakrashi is very supportive and knowledgable. She has an amazing bedside manner. I have been seeing her for 2 years now and therefore understand how to best communicate with her and receive recommendations. She is friendly and thorough in making sure I receive the care I need. She is also very responsive when I contact her with questions or concerns. I know that she and I share the same goals for my fertility.

Ask as many questions as possible and do not be afraid to re-ask the same questions or have information repeated back to you.

Cycle 1: Letrozole + progesterone since we were still at the beginning of my fertility journey. With the addition of progesterone, I got pregnant, but ultimately it ended in an ectopic pregnancy. Surgery to remove right tube. Cycle 2: Letrozole. We did not add progesterone because I was ovulating on the side where my tube had been removed. I did get pregnant, but also ended in an ectopic pregnancy with methotrexate shot to manage it. Cycle 3: Gonal-F + progesterone with timed intercourse. Levothyroxine added to treat hypothyroidism and reduce TSH levels. The goal was to produce more eggs. However in this cycle it seemed most of the egg production was on my tubeless side. No pregnancy resulted. Cycle 4: Gonal-F + progesterone = IUI. The goal was to produce more eggs again and also plant the sperm closer to the egg. In my honest opinion the IUI concept is flawed and a bit of a waste of money. Perhaps if there had been multiple IUIs done during this cycle, it might have worked, but this resulted in no pregnancy. Cycle 5: IVF using Menopur, Follistim, Ganirellix. The goal was to implant embryos. I was on a relatively low dose of Menopur and Follistim. Despite these low dosages, I was unable to have the Hcg trigger because of the risk of OHSS. Dr. Pakrashi was very attentive in making sure I did not get to sick and was very on top of my care. I used a lupron trigger for the egg retrieval and all embryos were frozen. Cycle 6: Frozen Embryo Transfer using estrogen patches and tablets and Endometrin inserts. The amount of Endomentrin inserts was increased due to not enough progesterone in my system. Cycle ongoing...

Most of my care was done through claims submitted to my insurance agency and out of pocket expenses. They do not take Tricare, but will submit claims on your behalf. The process is frustrating because you receive checks that then need to be mailed to EVMS.

Dr. Pakrashi sat down with me to discuss the risks and rewards with eSET vs multiple embryo transfer however she ultimately left the decision to me as the patient and I elected to for multiple embryo transfer.

If you want a caring compassionate doctor, Dr. Pakrashi is a must. She is warm and welcoming in a world that seem cold and isolating. I bombard her with questions every visit and she is also so patient in answering them no matter how trivial they may seem. I do feel like there could have possibly been tweaks to my treatment plans as we seemed to keep repeating what resulted in negative test after negative test.

As amazing as she is, you won’t always see her and you may be disappointed with some of the nurses and doctors in the practice.

1) Timed intercourse with Letrozole. 2) IUI with Gonal F and Ovidrel (3 cycles) 3) IVF - gonal f, menepour, progesterone, trigger shot

Monitoring appointments were always scheduled in the morning and wait time was on average 30 min - 60 min.

Our IVF cycle was approximately $19,000 including medications (not bought through clinic).

She is thorough, intelligent and extremely compassionate. I feel 100 percent comfortable under her care. She’s always optimistic yet honest at the same time. We have been through multiple failed cycles - both negative and miscarriages- and she is one of the reasons that I have the strength to keep going.

Be upfront and honest about your concerns or fears. She really does care and she wants to know!

I have PCOS and poor egg quality. Her recommendation was IVF ICSI but we still owe from our last IVF cycle and our toddler is diabetic, so we can’t spend out of pocket money on another. Since I have bad egg quality and I am 39, the goal is to get as many eggs as possible in hopes of finding a good one- like we did with my daughter!

We are 100 percent out of pocket do the cost is very high

Dr. Pakrashi was amazing because she was patient, and always took into consideration that this is an emotional time. I wish my experience had been like that from the beginning with others. She made me believe, and now, we have a beautiful daughter!

Be open and honest because she is there to help you through the process! She listens to everything that you say with empathy and compassion.

The treatment was specific to me, and the protocol that was used was specific to my body. Everyone on staff was on the same page with the treatment. She knew my history and knew what would work best for my situation.

The billing area was very helpful, and because it is EVMS, I was able to make a payment arrangement.

For us, it was a matter of what was fertilized and the decision was made on what would give us the best viability for pregnancy. Everything was very measured on giving us the best outcome.

Dr. Pakrashi was very kind and always felt like she really cared. She gave us a lot of hope and we plan on doing IVF with her. She also explained everything very well. She took the time to answer all the questions we had.

Write down any questions you have so you remember them all to ask.

We haven’t started IVF yet.

After IVF would be about 20,000 So far it’s been about 4,000

She is very compassionate and wants us to have another child. I believed she genuinely felt bad when a treatment didn't work. She would call and check on us and always start planning the next treatment.

Be patient

We did an IVF study that cost 4400, most other appointments were a few hundred